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Tai Ji Quan: Moving for Better Balance©: New Tips and Strategies for Success

Dawna Pidgeon, PT, TJQMBB Authorized Trainer

Sarah Gauger, MPH

June 19, 2019

Outline

•Brief overview Tai Ji Quan: Moving for Better Balance©

(TJQMBB)

• TJQMBB Updates: Level 1 & 2 Certification, Authorized

Trainer pathway

•Northeast Regional TJQMBB Training Center

•Challenges and Tips for Successful Program Implementation

•Central Support-Connecticut Model

Overview:

Tai Ji Quan: Moving for Better

Balance©

Tai Ji Quan: Moving for Better Balance© (TJQMBB)

• Research based

▪ Dr. Fuzhong Li, developer

▪ Combine TJQ and postural control science

▪ 1 hour classes, 2x/week x 24 week

• Decreases falls in RCTs by

▪ 58% in individuals 65 and older

▪ 67% in people with Parkinson’s Disease

• 75% fewer injurious falls(Li 2018, 2012, 2019)

Program Components

• Core routine: Tai Ji Quan: Moving for

Better Balance©

▪ 8 adapted “Yang Style” Tai Ji Quan

(TJQ) forms

▪ 10 practice variations that focus on

functional and therapeutic movements

• Subroutine: Tai Ji Quan - Mini

Therapeutic Movements® (MTM)

▪ Set of 11 exercises focusing on

integration of TJQ and therapeutic

training of balance and mobility

• Unique Features of TJQMBB

• Sensory challenges- vestibular, visual,

somatosensory

• Quick balance reaction training

• Limits of stability

Target Population

•Community-dwelling older adults with a history of falls, balance disorders, leg muscle weakness, abnormal gait or walking difficulty

▪ able to accommodate people with a mild level of mobility difficulty

▪ able to accommodate people with mild cognitive impairment

Instructor Training and

Certification Updates

TJQMBB Instructor Training

Instructor Training• 2-Day Instructor Training from

Authorized Trainer (16 hours)

• Annual Enhanced Training (8 hours)

• Trainings held at ORI or group training from Authorized Trainer

Authorized Trainers

• Authorized Trainer Location

▪Oregon, Washington state, Minnesota, New Hampshire

▪ Trainer-in Training: Florida, Michigan

Instructor Training Continuing Education Credits

• ACSM:

▪ 15 CECs are awarded for a 2-day Instructor Training workshop

▪ 6 CECs for an Enhanced Training Course

• Other professions/certifications

▪ Certificate of Attendance awarded

• Application procedure ACSM CEC

▪ A $25 check payable to Exercise Alternatives

▪ The name of the TJQMBB trainer from whom the applicant received the training

▪ Indicate whether it is (a) Community Instructor Training Workshop or (b) Enhanced Training Course

▪ E-mail and address of the applicant

▪ City/State the workshop or Enhanced Training Course was conducted and the dates

Program delivery support

•Class Teaching Plan

▪Booklet with each of 48 sessions outlined

•Videos of each form, practice variation and MTMs

▪With Instructor access upon completion of 2-day training: www.TJQMBB.org

•Authorized Trainer

Level 1 Certification Requirements

• Complete 16-hour TJQMBB Level-1 Community Instructor Training Workshop

▪ with a certificate of completion

• Complete 48 hours of teaching (1 class, 24 weeks) covering all class sessions described in the Class Teaching Plan completed within 12 months after the start of the first class

▪ a proof of teaching is required

• Demonstrate ability to teach a class with full compliance to program fidelity

▪ Completed Teaching Fidelity Checklist (www.TJQMBB.org)

o done by a certified peer or Authorized Trainer

Level 1 Certification (continued)

• Instructors who complete the

requirement will be certified

▪$25 fee payable to Exercise

Alternatives

• Level 1 Certification

required to become Level 2

certified

Level 2 Certification Requirements

• Level-1 Community Instructor certification

• Attend 1 8-hour annual Enhanced Training Course

• Provide a teaching video clip

▪ ~30 min in length for expertise evaluation.

o must contain performing the entire 8-form routine and teaching activities related to Forms 2 and 5.

▪ Mail the clip to Authorized Trainer who will forward to the TJQMBB office

• Proof of 144 hours of class teaching (3 classes) completed within 24 months after the start of the first class

• A recommendation letter from an Authorized Trainer

• A $75 fee

Authorized Trainer

Phase 1: Trainer in Training

• Hold a PT or exercise science degree or a currently valid certification from a well-known national or international fitness organization (e.g., ACSM, ACE, NETA)

• TJQMBB Level 2 Instructor

• Completion of a minimum of 5 hours of work with a TJQMBB Sponsoring Authorized Trainer

• Assist Authorized Trainer in conducting local TJQMBB Instructor Workshop

Phase 2

• Assist a current Authorized Trainer in conducting two TJQMBB workshops.

• Teach, directly and indirectly, a minimum of 16 hours of TJQMBB workshop activities as assigned and supervised by the Sponsoring Authorized Trainer

• Attend a two-day Train-the-Trainer workshop with TJQMBB’s developer at Oregon Research Institute in Eugene, Oregon

• Independently conduct one TJQMBB workshop under the supervision of a Sponsoring Authorized Trainer

TJQMMBB Northeast Regional

Training Center

GREAT Evidence, but… Challenging to Implement

•Authorized Trainer

accessibility

▪Initial two-day Instructor

training

▪Enhanced Training

▪Ongoing support

▪Certification levels

•Program length

▪Recruiting and retaining

participants

▪Recruiting and retaining

Instructors

•Sustainability and funding

Developing a Northeast Regional TJQMBB Training Center

Training

• Training Sequence

▪2-day Instructor workshop

▪1-day Implementation workshop

▪1-Day Enhanced Training

• Instructor Readiness Survey sent prior to workshop

Technical Support

• Regular contact and program

support Authorized Trainer

• TJQMBB website videos

•Monthly Technical Assistance

calls

Goal: Increase uptake and retention TJMQBB

Implementation Workshop: Structure

•4 hour workshop

▪+ 3 Hour Balance Day

Training

•Based on Implementation

science literature

•Structure

▪Activity

▪Didactic with question and

discussion

▪Action Planning

Organizational Readiness:

Mission Fit

Instructor Readiness:

Training

Support

Recruitment:

Marketing

Referral

Retention:

Attendance

Instructor

Sustainability:

Financial

Technical support

Recruitment and Retention: Getting the Right Participants

People who will

most benefit are

most likely to stay in

program

Retention: Keeping (the Right) Participants Engaged

• Take attendance

• Reach out when they miss class

Email from Instructor to participant:

“How are you doing? I’ve been concerned about you. I’ve missed you in the Tai Ji class and I hope that you are doing okay. Take good care of yourself and hope to see you in class again .”

Response from Participant:

“Thank you so much for your kind thoughts and wishes. I was kind of losing my faith in humanity; then I got your email.

I too miss all of you guys from Tai Ji. I was worried about coming back after missing so much, being a drag on the class. But now I look forward to seeing all you guys…”

Northeast Regional TJQMBB Training Center

Since August 2017…

•125 TJQMBB Instructors

Trained

•62 TJQMBB Classes

•40 sites

Connecticut

Connecticut Model: Centralized Support

•Connecticut’s Commitment to Fall Prevention

▪Section 17a-303a–Establishes fall prevention program through State Health Insurance Fund

▪Yale CT Collaboration for Fall Prevention

•CT Healthy Living Collective

▪Mission – Provide Access to Healthy Living Programs Throughout Lifespan

▪ Senior Center Collaborative - TJQMBB

▪ Statewide Mapping Project – TJQMBB & Matter of Balance

Connecticut Model: Centralized Support

•Organizational Readiness

▪Commitment to Fall Prevention for Clients and Community

▪Understand the financial and time commitment of TJQMBB Program

• Instructor Readiness

▪Completion of Dartmouth Instructor Readiness Survey.

▪State lead Participation – Instructor Training, Implementation Workshop, Refresher Training

oMaking the Connection – State to Local Level

oInstructor/Site Appreciation of Commitment and Connection

Newington Senior and Disabled Center

Connecticut Model: Centralized Support

•Recruitment

▪Connect with Other Fall Prevention Programs (Feeder Programs)

o CT Healthy Living Collective Mapping Project – Matter of Balance/TJQMBB

•Retention – One Size “Doesn’t" Fit All

•Sustainability

▪Small Grant Seed Funds – CT Fall Prevention Initiative, TIIID, Local Funding

▪Centralized TA and Support – State Unit on Aging/CT Healthy Living Collective

Thank You!Dawna Pidgeon , Dawna.M.Pidgeon@Hitchcock.org, TJQMBB Authorized

Trainer, Dartmouth Centers for Health & Aging

Sarah Gauger, Sarah.Gauger@ct.gov Prevention & Wellness Coordinator, CT

Department of Rehabilitation Services - State Unit on Aging

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